How I Manage
by LJ Summers
Summary: Carlisle Cullen's ability to resist the temptation of human blood is already legendary among his kind. His family reveres him. This is the story of how he manages. A birthday gift for u2shay, who requested a Dark Historical Carlisle from my hand.


**For u2shay, who LIKES it when I go all dark and historical. Happy Birthday!**

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><p>"Scalpel." I hold my hand out expectantly for Naya to set the surgical tool into my palm. She does so, her movements sure and firm. "Thank you." Naya has been the chief of my surgical nursing team since I arrived here in Forks. A former Army nurse, she is dedicated and entirely proficient in Surgery One. Outside of it, the woman is a vixen.<p>

She makes me smile.

I cut in to Roger Davies, the intensely sharp edge of the scalpel slicing through his skin only slightly less efficiently than a vampire's teeth might, and I eye the welling of his blood around the steel blade. His scent is alluring – it is human blood and I am a vampire, after all – but I am not bothered by it in the least.

I overlook the scent. My family knows it. I am a "wonder" to some of our kind.

At length, Mr. Davies' emergency surgery is over. "Thank you, Naya," I say to her. "Good job, everyone." Meeting with the patient's family is easy; I have used my preternatural abilities to save his life and his family is content.

I go home to _my_ family. Our house's lights shine in the pre-dawn hours, welcoming me. I know my wife will embrace me, our mutual arousal will escalate – it always does when we are apart for more than a couple of hours – and we will sate ourselves in our room before rejoining the others.

The "children."

They marvel and hold me up as some kind of paragon. Rosalie tries so hard to live up to the role I have displayed before her. _I'm going to be as strong as you have been, Carlisle, her attitude says every single day. I'm not going to feed from humans. Not ever._

Emmett occasionally claps me on the back when I return from work. "Don't know how you do it, man," he will say. We remember when he succumbed to his Singer, back in the 1950's. I never judged him for that.

_How can I?_ I asked him then. _We're vampires._

Esme and Alice, both of whom have partaken of our biological prey, honor my abstinence, reflecting that they could not have been so diligent. The burn is intense.

Jasper...tortured soul. He fights the fight every hour of every day. I honor his bravery and dedication, and I have told him so with words. The emotions, I know he picks up from me. I have learned how to purposefully push feelings his way. Encouragement, pride, the need for care.

"It is hard," he confessed to me once. "So hard. But Carlisle, you've given me hope. Hope that I can exist without making anyone feel the way I – I did, before. Thank you."

I have held him in my arms while he shook from the sheer need to feed. I have done that with them all. Jasper and Alice were not changed by my venom, but as they are members of my family, I care for them, too. We Cullens have a commitment to saving the lives of humans. It is our goal. It is one reason I became a physician.

Edward is my "firstborn," and he alone of all the family does not see me with the mild awe of the rest. He alone knows that I have borne my struggles and that I seek to do whatever is necessary – go to any length – to make amends for what we are, as vampires.

He alone knows how I can.

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><p><em><strong>New York City, 1800<strong>_

"There you go, Mrs. Thatcher. You heat that in front of the fire until it feels warm on your wrist and then soak a linen square in it and apply it to that rough patch on your skin. It'll clear up soon." Carlisle smiled, ignoring the burn in his throat. "I'll come by to see you in a fortnight, all right?"

"Thank you, Doctor Cullen," the lady of the house breathed, leaning in with a touch of lust sliding into her personal body scent. He was used to it, but having women express – subtly or otherwise – their attraction to him still made the once-upon-a-time son of a man of the cloth uncomfortable. "I so appreciate your help." Her accent was from Leeds, England. His own still carried the notes of London, though over the past hundred years, just _where_ in London might be in some doubt. Fortunately, as the United States of America was just getting on its feet as a nation, no one really argued overmuch with a London accent in a physician.

It was assumed he was better trained than a colonial apothecary.

Mrs. Thatcher pressed some coins into his hand. They had been minted in Philadelphia, and Carlisle was grateful for them. He had to have some of his surgical tools shipped in from England and that cost plenty of coin, for which the exchange rates were quite high. He could have done most of the surgeries with his own hands and – perhaps – teeth, but that wouldn't have gone over well at all. No. Instruments it had to be.

Besides, the blood... Well, he fought it, every single day. The burn was part of a vampire's existence and though he had once hated what he was with every part of himself, he now tried to make the best of it, using the gifts he was given as an immortal to serve humans. To save their lives.

Bloodletting was, ironically, a preferred treatment method among the colonials for all sorts of ills. He could smell their blood, of course, and sometimes it did seem that if he let out tainted blood – some diseases did affect a human's life in that way – their body would make new blood. Clean. Fresh.

As long as he had overcome his longing for it, the blood still sometimes called to him. The pain, the scratching dryness, the pulling in his guts... They eased up sometimes, but occasionally he felt as if he were in the lowest levels of Purgatory. The levels closest to Hell.

His walk back to his own modest, two-story home was easily made as dusk deepened into night. His leather shoes crunched on the small pebbles embedded in the dirt. The packed earth made for a fairly decent road during dry seasons, but in the rain, it was such a mess. For himself, Carlisle considered buying a cart and horse just to make things a bit easier, but horses didn't take too easily to vampires.

Mentally, the physician was reviewing his patients of the day, thinking of the notes he'd be making in his journal. Conventional medical wisdom explained things in terms of bodily humors. Once, Carlisle might have followed this school of thought. However, his existence as a vampire gifted with beyond-human sensory perceptions had taught him differently.

Still, he couldn't actually write any of that down, could he? If someone decided to go perusing his records – the Lord Above only knew why, but Carlisle had not gone on as long as he had by counting on people to make sense – he had to have notes that would mesh with what was currently considered to be standard medicine, no matter that the palliative measures were largely inappropriate.

He treated his patients his way and essentially lied in his records for unknown others. This kept him from standing out. The Volturi had impressed upon him the need to blend in; no matter that they lived as royalty, they did so in a contained place.

"If you choose to live among our...prey...my dear Carlisle, you will have to take precautions."

A significant look had passed to Carlisle from the most silent of The Three: Marcus. The look was meant to remind him about a conversation they had had, not too long before.

**. . .**

_The year was 1727, and Carlisle had been living in Volterra, Italy. Normally mentally tethered to Aro di Volterra, Jane of the Guard had leapt and drained a visitor in front of Carlisle. She had been violent, feral, uncontrolled – far from her normal demeanor. Marcus had blamed it on her bond with her Singer and Aro had let the infraction go._

_Carlisle approached Marcus privately later. "What did you mean, about The Singer?"_

_The Ancient leaned against the stone wall of his private chamber, steepling his fingers together as if his hands contained the mysteries of a cathedral in their stony recesses. "They are very rare, young Carlisle. We do not speak of them because it would be too tempting for the average vampire. Too tempting to seek out a singer. We risk exposure, you see, if we do so. As you saw with Jane earlier, there is no controlling the instant need to drain the Singer of all life."_

_"I saw, but why?"_

_"We are born with a burning thirst," he went on as if the younger vampire hadn't spoken. Marcus' voice was brittle, like parchment, but he spoke with heavy wisdom. "A thirst that will not abate in our entire existence. How you, with your unusual diet, do not go mad I don't know, but the burn is there for us all. There is only one way to slake it in a lasting way and that is to drink the blood that has been grown for the vampire. The one true fragrance, taste - however such things are measured, I do not know. But it can happen that the call of the blood of such a one is uniquely powerful to just one vampire. And if he drinks of the blood of his Singer – the one whose blood truly reaches to the innermost predatious part of the vampire – the burn is vanquished. Quenched. We – Jane and I – suffer with it no longer."_

_Carlisle was dumbfounded and looked it. "But how?"_

_A minute shrug. "I know not. I only know that – that I met my Singer long ago. She was an old woman. She was working the fields and her blood sang on the breeze. I ran to her, fed from her and was amazed that, days later, I had no burn. No real desire to feed. I do, of course. I do need to sustain myself but you might have noticed," he said, a sly smile on his lips as he finally met Carlisle's eyes, "that I am not ravenous. Nor do I feed on more than one human at a time. Really, Carlisle, you are perhaps the only vampire I could tell this to without the fear of exposure."_

**. . .**

The memory of this conversation never left his mind, of course, but as the burn and need to feed started to increase, Carlisle was dwelling on it perhaps more than he should have done_. I must hunt,_ he admonished himself, nodding at a young man leading an exhausted horse.

The scent of human blood curled under the good doctor's nose. He could almost see it doing so – red, beckoning, slipping, sliding.

_Sliding down his throat..._

_No!_ he shouted in his mind. _No_. The poor young groom with his stumbling horse had taken a tumble and the lad was injured. He might need stitches, but Carlisle was inured to ignoring hurts that no one had asked him to tend. The concerns over "witchcraft" were not far-removed no matter how modern society had grown in the past hundred years.

Resolutely ignoring any other humans on his way back to his house – which was also his apothecary and hospital – Carlisle swallowed venom back against the burn. He would change from his superfine coat and crushed velvet breeches, shed the neckcloth that helped to cover more of his skin, and change into dark stockings and felted breeches as well as a brown tunic and head covering. Not a proper hat by any means, it was what a peasant would have worn in an English countryside fifty years past. Without shape or definition, it flopped over his head, hiding the golden color of his hair to a degree – even from moonlight. It was tied on under his chin. If he were human, this would be restrictive; Carlisle, though, had only to doff the hat when he was directly chasing his prey.

He spent some necessary time pretending to make notes in his journal and pretending to fix himself some soup. His small windows were glazed and the lights had been noticed before by overly-zealous neighbors. He had learned to pretend to be human even within the confines of his own abode. Lantern lit and moving, fire coming out of the chimneys... All of it to make himself unnoticed.

At last, he blew out the candle in his bedroom – of course, he had one. Patients came and often stayed here so he could treat them effectively. He had a bedroom and a wardrobe and a wash stand. There was even a chamber pot placed with carefully-analyzed precision. Occasionally, he filled it with ash-tainted water and dumped it from a window.

He did so that evening as well, waiting exactly thirty-seven minutes before leaving the house. Keeping to human speeds, he still made to hurry. The woods to the northwest of the city teemed with game and he wanted to feed.

The heartbeat caught his notice first. It was fast – agitated, if his guess was accurate. The rapid thumping was accompanied by sturdy, running steps. Soles of shoes hitting the dry earth, occasionally grinding and stumbling. Panting breaths reached Carlisle next and, concerned, he paused in his own leave-taking from the city to find out if he could be of assistance.

A young woman was dashing, her path jagged and uneven as she kept checking over her shoulder. She was being pursued!

"Here, girl. Do you need help?"

She slid and slipped and caught herself on the ground, skinning the heels of her hands. "Sir!" No moon had yet risen, but the white of her servant's mobcap was a clear delineation of her station. She scrambled to her feet and tripped again to move ahead of her pursuer. She wiped her hands, then, and the motion of it all wafted her personal scent to Carlisle –

Who felt his eyes grow black. Blacker than black. Black with a lust for blood like none he had ever encountered. Ever. It would be a simple matter to reach for her, pinch nerves in her neck to make her unconscious and run out of town. Oh, he couldn't wait that long. No. He couldn't. He had to have her, now.

He swept her into his arms, covering her mouth with his own. "Silence," he rasped, his throat scorched by a thousand torches. The windows were dark up and down the street, but he could see a light, a torch's light to be exact, turning the end of the road.

"Dolly! Git yersel' back tae the house, girl! Damn yer eyes, I didn't mean tae scare ye!"

"Let me get you to safety," Carlisle whispered, already running with her in his arms. Her blood seeped out in minute quantities from her scraped hands. It pulsed with promise under the thin skin of her throat. Promises of the most lascivious fulfillments, the basest desires, the deepest, darkest _thirsts_.

The girl swallowed; her heart pumped more blood through her body. "Thank'ee, sir. I don' mean ta be a bother."

"No bother at all, girl. I'm a physician. I'll get you all patched up in no time." He spoke over the fire, through the flames of his desire for her. His finger squeezed the loose fabric in a desperate reaction and delaying tactic.

_Drink from her! Drink from her! Quench the fire forever!_

For she was his Singer. He recognized the strength of the burn, the boundless temptation, the need,_ the intensity of the thirst..._

"I have nothing with which ta pay ye, Doctor," young Dolly confessed into his shoulder, her head turned. She was a proud girl, for a servant. "But I'm that thankful that ye've rescued me. I was afeared o' my – for myself."

"I could see that," Carlisle remarked, approaching his darkened house. "Here we are. No trouble at all. I am happy to be of service."

He set her down and opened the door off his kitchen. It was, naturally, a tidy place revealed as he lit a lamp on the sideboard. He had a copper kettle on an iron stove and some towels hanging on pegs. Dishes on shelves set on the walls. In all respects, the kitchen of a bachelor. "Let's get you cleaned up."

Wordlessly, she let him lead her to a basin on the larger, rectangular table in the center of the kitchen. Pulling a cloth from the wall, he bathed her wounds in water.

_Drink, drink, drink._

His mind fought with his instincts. If he drank, he would never be able to forgive himself for having taken a human life. He could run. He could. His devotion to the preservation of life was still paramount. He could. He should. _I must..._

She smiled shyly into his black eyes. "Yer eyes're so dark, Doctor..."

"Dr. Cullen, miss."

"Dolly. Dolly Johns. Well, Dorothy, but I'm called Dolly."

_She has a name, man. She has a life. You can't take it from her._

He pretended to smile while he wrestled._ If you drink her, your Singer, you'll be free from the burn forever. Free from it. Think of the ease of treating future patients. Think of the peace of the rest of your existence. Lonely it will always be, but you will have your integrity!_

_The burn! I must have her. I must!_

She smiled again as he put a glycerin-draped bandage about her hand. The rich, tantalizing fragrance was barely muted. Carlisle felt himself actually grow aroused thinking of how she might taste. "Miss Johns. Will you be safe, walking home?"

Her former fear fell on her with an almost audible rustle. She shifted and looked out the road-facing window. "I – I don't know, Doctor. I think so?"

"Was that – that fellow a problem? Should we report him to the magistrate?"

Dolly's eyes grew wide under her cap and she pushed stray, caramel-colored strands of hair under its edges. Twin scents of fear and arousal reached Carlisle and he gripped the edge of the table, cracking the dry wood. Dolly didn't notice. Pulse, throb, swishing in her body._ I must... Not... I must... Not..._

"No, Doctor. I dasn't. It's my job, y'see. I need a place."

"Ah, of course," he said, drawn to come around the table to her side. "Well, I'll walk you home then, Miss Johns." He angled his arm and she stood, staring bewildered at it. "Well?" he asked with a charming smile after a moment. "May I walk you home?"

"Oh...that'd be so nice o'ye, Doctor..." she whispered, her blush clear. She slid her bandaged hand into the crook of his elbow and he bent his head, brushing her temple with his nose.

Oh, the scent of her. The heat, the pulsing blood. She sang to him, she truly did.

_No_! his gut protested._ No!_

_You'll be so much safer if you do. It's one human life balanced against how many? And you'll be saving her from possibly a worse fate..._

"Doctor..." she breathed, clearly not avoiding his proximity.

He didn't wait for further elucidation of her state of mind. Though his throat flamed, he turned to caress her girlishly rounded cheek with his lips. She gasped. Her heart sped within her breast. In a flash, he made his choice, picked her up and all but flew to the stairs.

"Dorothy," he whispered.

"Doctor...?" Her brown eyes widened when he set her down on the floor of his bedroom, but her flushed cheeks and parted lips showed him she was not averse to staying here for the moment. "What name should I call you?"

Taken aback, he chuckled lightly and removed his hat. "Carlisle Cullen."

He had never lain with a woman before, human or vampire. Still, the hungers in his body at this moment overwhelmed him. He swallowed back the seemingly endless fountain of venom in his mouth and reached for the young woman in front of him. "Dorothy..." Gently, he caressed her heated skin under her chin. She shivered. "May I?"

Her nod was not unexpected. With a soft moan, his lips covered hers, his hands pressed her into him, so that he felt the soft curves of her flesh. With a few moves that grew more desperate by the moment as her blood coursed beneath his lips, Carlisle ripped her outer gown, ignored her shocked exclamations, and stripped likewise in one of her heartbeats. Two.

And then, they were on his narrow, never-used bed and he called on everything he knew and had overheard to bring her what was, perhaps, the only pleasure in her life before her blood's call – the music of her heartbeat and the aroma of its treasure – pounded past his last vestige of denial.

Groaning under her breathy calls of, "Oh, Carlisle, ohhh...!" Carlisle bit her throat, severing the jugular so that her glorious fluids were, essentially, ejaculated into his mouth.

His own release came moments later.

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><p><em><strong>Forks, 2005<strong>_

Edward bursts into my office, where I am going over reports of my day in the Emergency Room. My firstborn is wild-looking. Feral in his stance. "Carlisle, I have to go. I have to go. Her blood – it's too much. If I stay, I'll kill her."

My mind flies immediately to Dorothy Johns and Edward sees her face, her expression contorted in orgasmic pleasure. I remember the incomparable taste of her and the wonder of the final quenching of the burn we all must live with as vampires. I meet Edward's eyes without a shield, without an excuse. "I'm so sorry, son," I whisper.

"My Singer? Bella Swan's my Singer?"

"The Chief's daughter?" _Oh, Lord in Heaven, what a mess_. "You know how it was for me."

Horror flares from his features. "No! I can't! No!"

He turns without another word and flees from me.

Is my son stronger than I was? I can only hope.

_**The End**_

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><p><em><strong>Now, I know it isn't exactly <span>canon<span>...but...ever think it could have happened? Thanks for reading! ~LJ**_


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